Application of a Clinical Practice Guideline for Persons with Multiple Sclerosis in a Multi-Setting, Multi-Discipline Rehabilitation Facility

Background: The Multiple Sclerosis (MS) clinical practice guideline (CPG) was created to assist the rehabilitation clinician in performing a thorough evaluation and develop an evidence-based plan of care. The development of a CPG was conducted to fit the unique mission, situation, and needs of Sheltering Arms Rehabilitation Hospital, its employees, and the community. The development and assimilation of this information represents a significant commitment to excellence in serving individuals living with MS across the rehabilitation spectrum of care, for a multitude of services. Persons with MS have variant disability levels and can present to rehabilitation services in acute care, home health, inpatient rehab, outpatient rehab and recreational fitness. The CPG was intended to provide the clinician in each setting, guidance on a thorough assessment and evidence- based plan of care, including an appropriate transition through the rehabilitation spectrum, into a long term fitness program.  

Objectives: A retrospective look at 2 different cases with implementation of a MS specific clinical practice guideline in transition through a multi-setting, multi-discipline rehabilitation to highlight consistency of practice and continuum of care for persons with MS. 

Methods: Two patients with a MS diagnosis were chosen to highlight the application of the MS CPG across levels of care and disciplines. Services utilized by these cases include in-patient rehabilitation, out-patient rehabilitation, medical psychology, and fitness/wellness.  Included are outcome measures that were taken at each admit/transition to next step of care and treatment interventions as each patient transitioned through their continuum of care.  

Results: Case summaries. 

Conclusions: Through the application of a CPG, the patients discussed received excellent outcomes and were able to make an appropriate transition through the rehabilitation spectrum, into a long term fitness program for independent management of their condition. Even with a heterogeneous patient population, consistency of practice and continuum of care is important in overall health and well-being of persons living with MS.